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Liposuction

For women and men who have isolated areas of fat despite a healthy lifestyle, Dr. Decherd offers liposuction in San Antonio. Liposuction is not used for weight loss (as some people think) but to reshape a specific body area. Common areas include outer thighs, inner thighs, and flanks.

Our staff is very helpful, and everyone here has been a patient of Dr. Decherd. We are happy to answer your liposuction questions at no cost to you. We also encourage you to request a consultation online with Dr. Decherd, or call our office at (210) 495-4100 to schedule a personal consultation.

In the meantime, find out more about liposuction by reading Dr. Decherd's answers below.

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What does liposuction involve?

I put in tumescent solution, which helps the process and really cuts down blood loss to very little. I then use a metal tube with holes in the end, and through a small incision and via a fanning motion; I remove fat from the affected areas. As we go, I switch to progressively smaller tubes (cannulas) to prevent contour irregularities. Afterward I have you wear tight liposuction garments to try and promote skin contraction and to help obliterate the potential space where the fat was.

Who is a good candidate for liposuction?

For liposuction to be successful one needs skin that will retract. After the fat is removed the skin needs to shrink down to show the new shape. If the skin tone is poor, then this won't happen. For example, if someone has had massive weight loss, liposuction is probably not a good option. Or, women who have had kids are usually not good candidates for tummy lipo, although they might be good candidates for, say, outer thigh lipo.

So the ideal candidate is probably someone who is in pretty good shape who has a couple areas that need reshaping. For example, there are some women who are in great shape but who have some fat deposits in the "saddlebag" area of the outer thigh. Removing this fat helps bring this one spot into proportion with the rest of their legs. Often pants will fit better.

What about the scar?

I do have to make some small scars. These vary depending on what we are doing and are usually not a huge issue.

Will I lose weight?

This is not a weight loss plan. It is a plan to reshape a specific body area. That being said, when it is all healed up there might be a small drop-off at the scale, as I do physically remove fat.

Will the fat reappear somewhere else?

I am unaware of a cosmic force that magically makes fat reappear elsewhere. However, if you gain some more fat, the fat will distribute throughout your body. As there are less fat cells at the site of the liposuction, then perhaps it will seem as if another area is gaining fat. For example, if you usually gain weight in the outer thighs, and then you get liposuction there, there are fewer fat cells there to accept new fat. So if you ease off the diet and exercise a little (which understandably may happen now that the problem area is better) you may notice weight gain in other areas.

Can't I just exercise the fat away?

Of course exercise is good. But I see women in great shape who have a pocket of fat that won't go away. Even if a woman got to be unhealthy-skinny she would still have some fat in these specific pockets. These pockets are amenable to liposuction.

What kind of anesthesia do you use?

There is a lot of misinformation in this area. Although it may be technically possible to do a very small amount of liposuction under local anesthesia, usually for the cases I see it would be prohibitively painful. While people talk about tumescent anesthesia, this is also confusing. If I do a small area under local I use tumescent anesthesia. If I put someone to sleep I also use tumescent anesthesia. Where it gets confusing is that some providers offer tumescent anesthesia, but they fail to mention the sedation that you get first. While we all take general anesthesia very seriously, it is actually pretty safe - probably safer than driving on 281 or 410 for most San Antonio residents. General anesthesia has improved from 50 years ago. This is not your grandfather's general anesthesia.

Michael E. Decherd, M.D.

A 4th generation Texas doctor, Dr. Decherd takes pride in the strong relationships he builds with his patients. He knows that cosmetic surgery is a "big deal" to you, and he's not happy until you are 100% satisfied.

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Michael E. Decherd, M.D.

On the other hand, sedation, while also generally very safe, is under-recognized, in my opinion, as having some issues. The airway is not secure. Aspiration is a risk.

One reason that some providers only offer sedation is that they can't go to the OR. To get surgical privileges, you have to be a surgeon. But wait, doc, isn't my liposuction surgeon a surgeon? Well maybe not. It's a terminology issue. They might have trained in family medicine, or dermatology, or even psychiatry. Legally, all you need is a medical license. As an example, Ronald Reagan participated in a democracy and therefore was a democrat. But he was a Republican democrat, not a Democrat democrat (Big "D" versus small "d"). So by circular logic the doctor performing surgery is a surgeon (by definition), but he or she may not be a board-certified plastic surgeon.

And, by the way, who performs the sedation? It may be the same provider who is doing the procedure. Or a nurse. While neither is necessarily wrong, I use M.D. anesthesiologists, who are pros in sedation, anesthesia, and other issues like that. The whole job of this doctor is to give you a safe relatively painless experience during the procedure. If I personally receive ANY sedation or general anesthesia, I will absolutely have a board-certified anesthesiologist running that part of the show.

What is the recovery?

People bruise variably. The pain feels like the pain associated with a bruise. Usually bruising is gone after a few weeks. I think that the "acute" swelling takes about two months to go away, and then there is some subtle remodeling over the next year or so. We have you wear a compression garment for two weeks around the clock (except for showering) and two more weeks at night.

How do I maintain my results?

To keep your new look, let's talk briefly about liposuction. Lipo removes fat. Period. So some people need fat and skin removed, and these people are better served by excisional procedures. For lipo to work well, we need the skin to retract. For this to happen we need good skin tone and sometimes a little luck. People who have lost a significant amount of weight usually do not have the needed skin tone to be a good candidate for liposuction. Women who have had kids may do better with a tummy tuck.

In the immediate post-op period I have you wear tight liposuction garments to try and promote skin contraction and to help obliterate the potential space where the fat was. This goes on for about 4 weeks. I think by 8 weeks most people have most of the swelling gone, although there is subtle remodeling over the next 12 to 18 months. Once it is healed up, you can gain and lose weight throughout your body, including the treated areas, but they should maintain their general contour relative to the rest of your body.

How much does it cost?

Unfortunately, there are costs associated with cosmetic surgery, and with liposuction in particular. Some women need more work than others, and therefore the cost may vary from one person to another. And more body areas obviously is more work than less body areas and therefore generates more costs. Let me be clear—my first goal is to provide quality care and meet your expectations. We treat every patient as an individual. While we might be able to give you an idea of costs over the phone, we really need to see you to give you an exact cost. And when we quote fees we will quote you the entire cost-facility, anesthesia, surgeon, and any other ancillary fees. Usually the only extra costs are prescriptions.

Conclusion

Liposuction is a procedure to reshape a specific body area. Feel free to browse my before-and-after photo gallery to see some results (although I think that sometimes results are easier to feel inside your own skin than see in a picture when it comes to lipo).

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San Antonio Plastic Surgery Institute Dr. Michael Decherd
San Antonio Plastic Surgery Institute
414 W Sunset Rd #215
San Antonio, TX 78209
Phone: (210) 495-4100
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